STONYBROOK MENTAL HEALTH (NPI# 1811480452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811480452 |
| Entity Type | Organization |
| Organization Name | STONYBROOK MENTAL HEALTH |
| Practice Address |
875 Hammond St Bangor ME 04401-4303 |
| Mailing Address |
Po Box 72 Holden ME 04429-0072 |
| Practice Telephone | 2076648529 |
| Mailing Telephone | 2076648529 |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2018-06-08 |
| Authorized Official Name | MR. RICHARD G COREY (OWNER) |
| Authorized Official Telephone | 2076648529 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | Agencies | ||
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| Y | 252Y00000X | Early Intervention Provider Agency | Agencies |
| Street Address |
875 HAMMOND ST |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-4303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235186271 | R. Joseph Libby, D.m.d., P.a. | Dentist | 875 Hammond St, Bangor, ME 04401-4303 | 2006-05-27 |
| 1972664431 | John Michael Caruso | Dentist | 875 Hammond St, Bangor, ME 04401-4303 | 2006-12-12 |
| 1659307502 | R. Joseph Libby | Dentist | 875 Hammond St, Bangor, ME 04401-4303 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 252Y00000X |
| Grouping | Agencies |
| Classification | Early Intervention Provider Agency |
| Early intervention services are an effective way to address the needs of infants and toddlers who have developmental delays or disabilities. The services are made available through a federal law known as the Individuals with Disabilities Education Act (IDEA). IDEA provides states and territories with specific requirements for providing early intervention services to infants and toddlers with special needs. In turn, each state and territory develops its own policies for carrying out IDEA and its requirements. Broadly speaking, early intervention services are special services for eligible infants and toddlers and their families. These services are designed to identify and meet children’s needs in five developmental areas. These areas are: physical development, cognitive development, communication, social or emotional development, and adaptive development. |
| Notes: Source: National Dissemination Center for Children with Disabilities [7/1/2007: new] http://www.nichcy.org/pubs/parent/pa2txt.htm |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659609576 | Blue B Inc | Early Intervention Provider Agency | 306 Essex St, Bangor, ME 04401-4051 | 2009-12-04 |
| 1174851018 | Blue School Inc. | Early Intervention Provider Agency | 1000 State Street, Bangor, ME 04401 | 2009-12-04 |
| 1851531883 | Linda Michelle Lasher | Early Intervention Provider Agency | 53 N 9th St, Bangor, PA 18013-1622 | 2009-03-04 |
| 1811124662 | Watch Me Shine, Inc. | Early Intervention Provider Agency | 28 Gilman Plaza, Bangor, ME 04401 | 2009-06-19 |
| 1780828285 | Winnie The Pooh Nursery School | Early Intervention Provider Agency | 56 Center St, Bangor, ME 04401-5003 | 2009-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013310630 | Dragonfly Academy LLC | Early Intervention Provider Agency | 4 Madawaska Rd, Palmyra, ME 04965-4032 | 2014-09-28 |
| 1881902815 | Autism Solutions | Early Intervention Provider Agency | 23 Beechwood Dr, Winthrop, ME 04364-3314 | 2010-09-24 |
| 1790005544 | Highland Pre-school | Early Intervention Provider Agency | 29 Kennebec Rd, Hampden, ME 04444-1315 | 2010-06-03 |
| 1952631673 | Great Expectations | Early Intervention Provider Agency | 17 Veterans Memorial Drive, Windham, ME 04062 | 2009-12-31 |
| 1053649046 | Child and Family Opportunities, Inc | Early Intervention Provider Agency | 18 Avery Ln, Ellsworth, ME 04605-2530 | 2009-12-02 |
| 1760618235 | Teen and Young Parent Program of Knox County, Inc. | Early Intervention Provider Agency | 231b Park St, Rockland, ME 04841-2127 | 2009-06-10 |
| 1396970703 | Carrie J Pierce | Early Intervention Provider Agency | 33c Ledgewood Dr, Hampden, ME 04444-1025 | 2009-05-29 |
| 1013141928 | Washington County Children's Program Board | Early Intervention Provider Agency | 14 Steve's Lane, Marshfield, ME 04654-0000 | 2009-05-06 |
| 1336373588 | Coastal Kids Preschool | Early Intervention Provider Agency | 12 Jackies Trl, Damariscotta, ME 04543-4253 | 2009-05-03 |
| 1518101740 | Washington County Children's Program Board | Early Intervention Provider Agency | Rr 1 Box 341, Us Rt 1a, Harrington, ME 04643-9714 | 2009-05-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.